CAJ | 학술논문

目的检测原发性肝细胞癌（HCC）患者射频治疗前后血清中磷脂酰肌醇蛋白聚糖3（GPC3）的含量，初步探讨其在疗效评价中的临床应用价值。方法采用酶联免疫吸附法检测59例HCC患者、35例肝硬化患者、对照组30名健康者血清中GPC3的表达，其中30例HCC患者经射频治疗，对射频治疗前与治疗后1 d、5 d、30 d血清中GPC3含量进行比较，Logistic回归模型进行HCC患者射频治疗后GPC3表达水平波动的危险因素分析。结果 HCC患者血清GPC3含量明显高于肝硬化患者和健康对照组人群，对比三组间的差异有统计学意义（ P均＜0.01），HCC患者射频治疗后不同时间点GPC3含量较治疗前明显下降（ P＜0.01），快速复发患者GPC3含量有显著升高波动（ P＜0.01）。结论 GPC3含量在HCC中表达显著高于肝硬化及正常对照组，特异性好，与AFP表达无明显相关性，联合诊断更有利于提高HCC的诊断敏感性，射频消融治疗后不同阶段GPC3均有不同程度降低，GPC3浓度的变化与快速复发有关，在疗效评估及预后判断有一定临床价值。
목적검측원발성간세포암（HCC）환자사빈치료전후혈청중린지선기순단백취당3（GPC3）적함량，초보탐토기재료효평개중적림상응용개치。방법채용매련면역흡부법검측59례HCC환자、35례간경화환자、대조조30명건강자혈청중GPC3적표체，기중30례HCC환자경사빈치료，대사빈치료전여치료후1 d、5 d、30 d혈청중GPC3함량진행비교，Logistic회귀모형진행HCC환자사빈치료후GPC3표체수평파동적위험인소분석。결과 HCC환자혈청GPC3함량명현고우간경화환자화건강대조조인군，대비삼조간적차이유통계학의의（ P균＜0.01），HCC환자사빈치료후불동시간점GPC3함량교치료전명현하강（ P＜0.01），쾌속복발환자GPC3함량유현저승고파동（ P＜0.01）。결론 GPC3함량재HCC중표체현저고우간경화급정상대조조，특이성호，여AFP표체무명현상관성，연합진단경유리우제고HCC적진단민감성，사빈소융치료후불동계단GPC3균유불동정도강저，GPC3농도적변화여쾌속복발유관，재료효평고급예후판단유일정림상개치。
Objective To detect the concentration of Glypican-3 ( GPC3 ) in serum before and after the radiofrequency ablation(RFA)for hepatocellular carcinoma(HCC)patients,and investigate its clinical value in the efficacy evaluation initially.Methods The concentration of serum GPC3 in 59 patients with HCC,35 patients with cirrhosis and 30 healthy control subjects were assayed with ELISA , and the GPC3 levels in their serum of before-treat,1-day,5-day and 30-day after RFA were compared .The principal risk factors of the fluctuation of GPC 3 content in the patients with HCC after RFA was analyzed by logistic regression model .Results The content of GPC3 in serum of HCC patients was significantly higher than that of cirrhosis patients and the healthy control group crowd ( P<0.01 ) ,and the GPC3 content of HCC patients in different time after the RFA treatment was decreased contrasted with that before treatment ( P <0.01 ) , which of the patients with little survivorship and rapid recurrence had significant fluctuation of step-up( P<0.01 ) .Conclusions There were high detection and specificity of GPC 3 in HCC compared with cirrhosis and the healthy control group , with no significant correlation to AFP expression .The joint diagnosis was much more conducive to improving the diagnostic sensitivity of HCC .The levels of GPC3 in different time after RFA were all reduced to some degree , which was concerned with little survivorship and rapid recurrence.Therefore,the detection of GPC3 possessed good clinical application value .